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HomeMy WebLinkAboutWAI2025-00056 - WAI Health Waiver - 8/4/2025 ie„.:G'PLh. . Jr : • MASON COUNTY h COMMUNITY SERVICES M14 Building,Planning,Environmental Health,Community Health 415 N 6"'Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 Belfair: (360)275-4467 ext 400 ❖ Eima: (360)482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeal j([ L�t5 1 Amount Paid: 1 }i '>�30 }; lt AuG it t+ I075 p Recei t Number: a _ 013 \ Iu Instructions (JET 0005(p ` By 1. Complete Parts 1 and 2. No determination can be made until these parts are fully completed. 2. Fees may be billed for waivers and appeals, based on the Environmental Health Fee Schedule. 3. Submit completed application with attachments to Mason County Public Health for review. PART 1. Applicant/Parcel Identification Name of Applicant Richard Shuier Telephone 360-620-6416 Mailing Address of Applicant PO Box 54 City Grapeview State WA Zip 98546 12-digit Tax Parcel No. 1 2 1 0 8 _ 5 0 _ 0 1 0 0 5 Site Address 510 East Lombard Road South Subdivision Name and Lot Pirate's Cove BLK: 1 LOT: 5 & s1/2 LOT: 4 &T.L's PART 2: Nature of Waiver/Appeal O Contractor Certification Requirements >:4 Class B Reduction in Vertical (Installer, Pumper, O&M Specialists) ❑ Separation 0 Food Sanitation Requirements ❑ Building Permit Review Policies 0 Group B Water System Regulations ❑ Location,WAC 246-272A-0210 0 Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 0 Enforcement Timelines ❑ Mason County Onsite Standards 0 Departmental Determinations ❑ Other Description of Waiver/Appeal(include justification, additional material may be attached.): Current deck is unsafe. New deck footings 48"from drain field.All footing to be hand dug. Applicant Signature: .69G 144,4K Date: 7/31/2025 J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 1 of 2 PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) Appeal .Waiver None required - Class A Class B Class C (..„0C 2. Identification of Specific Code/Standard/Determination (include date of determination or latest Code/ Standard revision) 3. Nature of Appeal: ju ( ^ !� /�-,m lt v 02- �ofi s -� d2 rhynly rvt� 4. Hearing Official: ❑ Board of Health ❑ Health Officer O Pollution Control hearing Board 0 Public Health Director ❑ Certified Contractor Review Board y Environmental Health Manager 5. Mitigating Factors: 0 W _ f a 6. I have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. Staff Signature: Date: PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public health and is hereby granted.This decision is based on the following findings and conditions: ❑ The hearing official has determined that approval of this request could potentially adversely effect public health and is hereby denied. This decision is based on the following findings and conditions: Hearing Official Signature: Date: ` 0 Z/.f J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 2 of 2 N • x r U c - F. m 4 s2 a EC'' F LL r V1 ¢ 3 ?• K O Z O N _C g O O QNa Z - o p h c i w z P o o a a H .> i g a a N , ui o re?. m LL 7 6 Ckk o n F = i re0 0 N 2 N TS . I E I @g w €LL 1 QN E`. u2n't9w � am o T� gy 2 2203 1 Z o• �AqYw oa;O 1 N Q 1% a � �.¢QNLL • 209.10 1 :I c. -� I • i . i • < E C_I-_, 1 -', ) 4? (...,,, U 1 : 1o � : (..-r m /LI' i '. o . I/i II ' I •a h ! a • o a. r • ii:') 1p m � i • O y m n Is a W i :•� 11 I I • I 'I I N I. I : • II CO w Lc) WO Oo 0W w W co co 0 II bN YO °▪ a I ` -2 �� W Z c E 5 1 0 D a) J Z • W N O Cn 'Go. • o) Iam ., a w m C g ., .� u Q a E 3 0 n 4 ri P<: E tm o CO t F x e � u og �J 2 •W A : : 's B Ea S b;4 & �I A"--- I \._ the \)4" //// \\\\‘ \s''\ 1 I li 1-A 9 1 1 . 1 1 1 1 L i 1 1 '--i I r 1 1 1 1 1 1 1 --.... ____1 \ 1 1 1 © 1 1 1 r 2 1 1 . I I A I — o 1 1 � I e I' g o 1 k — R h __— a I I I \, I po 1 5 p . i U 11 2 1 m 1 o .. to i 7 rill . 1 1 k, C I I V ^i xo p y 1 1 N$ t J F , ) ---3[4]--\-- \ . _.. ......._ Ail 6,14 i I l 11.. J I 0 0 ii i o xr cv N-- o J 2.4 ta III v i CZ q Q. N V. Z 7 1 1 ---- - ..) te 4 / I ! ,,, m a q .,0 au� w a • o I. I �t+ x gn c� Q qn m d w N" 1 F m.G \ 1 1 ill. iii(Z1 . F.652 C.' x I st r E. 1 I ..� . § W Q ..{.;.\ 1 N 10 \ -- \ -,-,:= I O Z I (I I s O — I 1 uP,. E �. J t I J i \ 'N' Y .. " ,Ia° I . g In rf;1). €ramco .. �:!- 11 OZT g a E N .Z O t► J W 9 ca ' . I A.Ot